자세변동에 따른 안압의 변화와 안구박동크기와의 관계
Positional Change of Intraocular Pressure and Its Relationship to Ocular Pulse Amplitude
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목적: 녹내장 및 녹내장의증 안에서 자세변동 후 시간에 따른 안압의 변화를 관찰하고 이러한 변화 양상이 안구박동크기 등의 안인자와 어떠한 상관관계를 보이는지 알아보고자 하였다. 대상과 방법: 총 46안을 대상으로 먼저 앉은 자세에서 골드만압평안압계, 파스칼안압계, TonoPen®을 이용하여 안압과 안구박동크기를 측정한 뒤 똑바로 누운 자세에서 누운 직후, 누운 지 10분 후 그리고 30분 뒤 안압을 TonoPen®으로 측정하여 앉은 자세에서의안압과의 차이를 측정하였다. 이러한 안압의 변화가 안구박동크기 등 여러 가지 안인자와 어떤 상관관계를 보이는지 알아보았다. 결과: 앉아서 측정한 TonoPen®안압은 16.6 ± 2.9 mmHg였으며 안구박동크기는 2.57 ± 0.89 mmHg였다. TonoPen®으로 와위를취한 직후, 10분 뒤 그리고 30분 뒤 측정한 안압은 각각 17.6 ± 2.9 mmHg, 18.2 ± 3.7 mmHg, 17.5 ± 2.7 mmHg이었다. 각 자세변화와 시간에 따른 안압은 모두 통계적으로 의미 있는 차이를 보였으며 누운 후 10분 뒤 안압의 변화가 가장 컸다. 누운 뒤 10분 후의안압 변화는 안구박동크기(R=0.340) 및 굴절이상정도(R=0.330)와 양의 상관관계를 보였으며 안축장(R=-0.410)과는 음의 상관관계를 보였다. 결론: 자세변동 후 시간에 따라 안압이 상승하는 양상을 보이다가 다시 상승 정도가 줄어드는 것을 확인할 수 있었으며 또한 자세변동에 따른 안압변동은 안구가 클수록(안축장이 길수록) 적으며 안구박동크기가 클수록 컸다.
Abstract
Purpose: To investigate the postural change of intraocular pressure (IOP) from sitting to supine position and determine the relationshipto other ocular parameters including ocular pulse amplitude (OPA) in glaucoma suspect and open angle glaucomapatients. Methods: The present study included 46 eyes of 46 patients. First, we measured IOP and OPA using Goldmann applanation tonometer(GAT), Pascal dynamic contour tonometer and TonoPen®. Using TonoPen®, the IOP was measured immediately afterthe subjects were placed in a supine position and 10 minutes and 30 minutes thereafter. We also investigated the correlation betweenpositional change of IOP and axial length (AL), refractive error (RE), and OPA. Results: IOPs of patients in a sitting position measured with GAT and TonoPen® were 15.3 ± 3.3 mm Hg and 16.6 ± 2.9 mm Hg,respectively, and OPA was 2.57 ± 0.89 mm Hg. IOPs measured with TonoPen® were 17.6 ± 2.9 mm Hg immediately after positionchange, 18.2 ± 3.7 mm Hg after 10 minutes and 17.5 ± 2.7 mm Hg after 30 minutes. Each IOP change was statistically significantand the largest change was after 10 minutes. Changes of IOP after 10 minutes were positively correlated with OPA (R =0.340) and RE (R = 0.330) and negatively correlated with AL (R = -0.410). Conclusions: When placed in a supine position, the IOP of patients increased and then decreased over time. Positional IOPchange was influenced by AL and OPA and variable hemodynamic factors and apparently influenced OPA and ocular perfusionpressure.
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